Intended for healthcare professionals


Dangers of long term use of cardiovascular drugs and other stories . . .

BMJ 2015; 351 doi: (Published 23 September 2015) Cite this as: BMJ 2015;351:h4972

To paraphrase Dr Samuel Johnson, a close brush with death concentrates the mind wonderfully. In a letter to the Lancet early this year, Desmond Julian, the British cardiologist who introduced coronary care units, described two potentially fatal events that were attributable to the β blocker he had been taking for decades. Now, he and colleagues have followed this up with a challenging piece on the long term use of cardiovascular drugs (Journal of the American College of Cardiology 2015;66:1273-85, doi:10.1016/j.jacc.2015.07.018). They look at four classes—aspirin, statins, β blockers, and angiotensin converting enzyme inhibitors—and contrast the known potential harms of these drugs in older people with the lack of randomised trial evidence of long term benefit in most conditions.

A study from Nottingham measured serum osmolality in 200 acute medical patients aged 65 or more (Age and Ageing 2015, doi:10.1093/ageing/afv119). On admission, 37% were dehydrated, and of these 62% were …

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